A recent study published in Colorectal Disease assessed the cost-effectiveness of sacral neuromodulation (SNM) compared with conservative treatment in children and adolescents with constipation refractory to conservative management. Here, Markov probabilistic model was used, to compare the cost-effectiveness of SNM and conservative treatment in children and adolescents aged 10-18 years with constipation refractory to conservative management. The participants included 30 female patients with a mean age of 16 years, with functional constipation, refractory to conservative treatment. The mean duration of laxative use in this group was 5.9 years; median follow-up was 22.1 months. The results showed that the mean cumulative costs for the SNM group and the conservative treatment group were €17,789 and €7574 per patient, respectively. The mean quality adjusted life years in the SNM group was 1.74, compared with 0.86 in the conservatively managed group. The findings indicated that SNM can improve symptoms and quality of life at a reasonable cost, and is thus, considered a cost-effective treatment option.